Dessima was finding everyday life gloomy. It was so hard to readjust. She and her new psychiatrist shared a vague mutual dislike. At their first meeting, for a few seconds she had felt an elusive attraction to him; she was never to understand why and it would never be repeated.

One Saturday, he came to their appointment damp and disheveled in his reserve officer’s uniform, his thin hair plastered to his forehead. “Dr. Drayton is a sweaty WASP,” she thought. He was stiff and tense and lacked that air of professional kindness she’d always assumed was an intrinsic part of therapy. He provided her with instant coffee, hard candy, hard plastic furniture.

It was to a colleague of his, Dr. Corsen, that she was referred for her pregnancy test and abortion. Dessima had gotten pregnant on the day she walked off the grounds of Shepard Pratt, an expensive hospital that specialized in treating troubled adolescents. Now she was back at Temple University once again as a liberal arts undergraduate, living in the nurses’ dormitory way up on north Broad Street because there were no dorm units left for late registrants on the main campus. In the space she shared with an occupational therapy student, the same cloying Streisand songs played over and over. She decided to switch rooms.

Her new roommate, Renee, worked part-time as a waitress and kept a box of tip money in the drawer. Her father was a successful realtor, but her family, which lived out on the fashionable Main Line, was breaking up. Renee felt a clutching attraction to Kevin, a leader of SDS, because he had been to reform school. She gossiped about her friends who were also chasing him, and gloated when he called one of them “Porky Pig.”

When Dessima looked back on the period, she had a dim recollection of hours spent in cavernous student lounges trying to read and study things. She gave equal time to text and footnotes of Shakespeare’s histories, equal weight to each sentence.

It bothered her that Shakespeare was taught by a coiffed, uptight woman on the verge of retirement who smirked and grimaced when she wanted to convey her dissatisfaction and annoyance with the students. A taxi dropped her off in front of the building each day right in the heart of Temple’s ghetto campus.

Her other English instructor was more like a real college professor. He had a genuine enthusiasm for American literature and was transported by the joy of hearing America singing and never noticed Dessima was in the class, even though she wrote a paper comparing William Morris with Edward Bellamy. He carried on a nearly private dialogue with a certain older student, giving the class an atmosphere of a small liberal arts college instead of a commuter sidewalk university.

Even though Dessima had been institutionalized and was seeing Dr. Drayton three times a week, in order to obtain a legal abortion she had to see yet another psychiatrist, an associate of Dr. Corsen’s, who demanded she come in for a second appointment because she had been five minutes late for the first. It took two sessions, paid in full, to ascertain that she was sufficiently disturbed to qualify for an abortion.

If arranging the abortion was not a simple matter, the operation itself was not the simple routine procedure predicted.

“We had to cut you open,” Dr. Corsen said, as she awakened from the anesthesia. Because the cervix could not be dilated, an abortion by Caesarean section was performed. This was followed by a postoperative “vacation” from school, the dropping of French, of physics, no climbing stairs so the awful gash could heal, and lots of shots after the operation. Depo provera. Dr. Corsen was in an ecstasy of experimentation with the drug. Unbelievable depression followed.

Her cousin Ted, a medical student, said that Dr. Corsen may have perforated her uterus by accident and cut her open in order to sew it up. Ted thought that rather than going home it might be psychologically easier for Dessima to spend Easter vacation with him and his wife. They arranged for her to stay in a communal apartment across the street inhabited by his wife’s younger sister, Laura, and various friends.

At least seven other people lived in the apartment on Pine Street, including future rock stars Daryl Hall and John Oates and a barber who had just gotten out of jail. And then there was David, or “David the drag,” as Laura liked to call him–who would say things like “If you’re not a leader you’re a follower”–so it wasn’t surprising when he ended up stealing her boyfriend John’s guitar. Even thought Dessima wasn’t attracted to David, she almost slept with him. But her wound from the hysterotomy was giving her trouble and she showed it to him and they were both turned off.

Lying on the mattress one day during Easter break, Dessima thought she might act on an involuntary impulse to jump out the window.

She realized that although she was temporarily able to rely on her parents, she soon would have no way of supporting herself. Privately obsessed with this hopeless matter, she’d never mentioned it to anyone because she felt it was unsolvable. At various times in her teens she had applied for jobs as a messenger, a telephone operator, a library assistant, but wasn’t hired. She had been fired from a job at a dental lab after two days. So when spring vacation was over, motivated by fear, she took a part-time job as a file clerk in the student records department at Temple, realizing that even if she were working full-time, at $1.60 an hour, she wouldn’t make enough money to live on.

She had dropped French and physics, so just the two English courses remained. And her job as a file clerk. She told Dr. Drayton she felt nervous and thought she needed a tranquilizer. He put her on Haldol; it was then that an implacable sense of being borne along toward suicide emerged for the first time. But she had to complete her two remaining courses.

It was only after the new agitation brought about by the medication was becoming physically unbearable that she decided to have herself admitted to the psychiatric ward at Hahneman Hospital. Twelve stories up. Dessima thought that the packed elevator that bore her to the top floor might crash but didn’t care. It moved very slowly, everyone looking up at the dial.

There were a billion student nurses on the floor. Dessima wanted to go to sleep but they made her draw a still life. She scratched out a pencil rendering of dried flowers. “That’s good,” one of the student nurses said. She ate mechanically, hating to eat, only enjoying slightly the pineapple upside-down cake that they offered every day as one of the menu choices.

She could not sit still; she could only pace back and forth, her tenseness assuaged solely by sleep. They tried to make her sit in a circle with the other patients, but the sheer pain of remaining stationary was unbearable. The drug taken to overcome the side effects of the Haldol didn’t seem to help. And they would not let her lie down.

Dr. Drayton emphasized to Dessima that the staff did not like her. With some ceremony he reached into his briefcase and pulled out a giant lollipop and handed it to her, accompanied by a suggestion that she should grow up.

Dessima thought that she would end up in a state hospital. She asked the floor administrator if by jumping from the twelfth floor you would die before you hit the ground. He said, yes, you would have a heart attack. So she spent much time alone before the unattended open window in the twelfth-floor vestibule, but was not able to do it.

The administrator was working full time and going to school full time. He congratulated her when she was released from the ward and assigned to the day hospital, as if it were some sort of milestone in her life.

At the day hospital, every afternoon one of the patients went down to Horn & Hardarts to pick up the lunch. You could have a quarter of a pie for dessert if you liked and you could lie down on the couch when you wanted. But the problem was that the TV was on most of the time. Or Rudy, an attendant, would play his favorite song, “Heard It Through the Grapevine,” and everyone got up to dance, dance, dance. Rudy could show just the right amount of bullying and approval to be effective with the patients, but it didn’t work with Dessima because he made no effort to conceal the fact that he didn’t like her.

At least she was left alone sometimes. She drank Coke and was surprised at how rich and good and totally refreshing it tasted. A patient named Penny, a premature adult with a petulant, little-girl mother, showed her the “wonderful” supplies–poster paint, clay, old magazines, scraps of paper–one’s creativity would know no bounds here, Penny gratefully implied, in her beautiful singsong voice.

Now that the semester was over, Dessima lived at home with her parents. Every day her mother walked her to the day hospital; she was conscious of her arms hanging and wasn’t sure where they should go. She knew she would never be able to hold a job.

She began to question Dr. Drayton about how to commit suicide. One day, when he walked out of his office, she reached into a drawer and scooped up handful upon handful of sample pills–she had no idea what they were.

When she got home she made dinner for her parents, chicken prepared on top of the stove. Her mother was trying to teach her to cook by typed instruction. Dessima had never learned how to cook because she was afraid to light the gas oven. She burnt the chicken, and her father was convinced this is what provoked her act.

Cupping her hands at the bathroom sink, she swallowed every one of Dr. Drayton’s pills, and came into the living room and announced what she had done.

Her mother grabbed her and Dessima vaguely remembered falling over again in the cab and in the emergency room. Someone was trying to make her sit up.

And then someone was trying to make her turn from her stomach to her back. And someone was cursing at her for turning on her stomach.

Penny from the day hospital was calling her and beckoning her to a wonderful garden. She was walking through a green, ethereal place somewhere in the southwest of the city to which Penny beckoned her. There were gates and gardens, fountains, trees and vast spaces. Then she stumbled into a far more vibrant underground place, like the city she was told as a child existed beneath the grates in Rittenhouse Square, a twilit chasm with small streets and alleys and underpasses with black gates that clanged open and shut. She always just missed fully seeing anyone, only catching a quickly moving silhouetted figure as she turned a corner or someone entered a gate, but she herself was lucidly observed. She felt she could stay here forever, but someone was wrenching her away, pulling her onto her back.

She opened her eyes and realized that she could not speak. Just the sound of air gushed from her; there were no words. A nurse who stood by her bed heard and understood everything she was trying to say. There was a needle in her arm, and a catheter.

She had been in a coma for five days, and men had landed on the moon, and Ted Kennedy’s career had been unlaunched at Chappaquidick. The Haldol had left her system so she could walk normally again. She thought maybe she would try to become a kindergarten teacher.

She decided to stop seeing Dr. Drayton. As she awoke in intensive care, he had been her first visitor, warning he’d appreciate it if she didn’t mention where she got the sleeping pills, as if it were the least she could do for him. He insisted on being present when she met with the hospital’s staff psychiatrist, so that the issue never came up.

With a slight twinkle in his eye, Dr. Drayton observed, “It feels like we’re a married couple, trying to decide whether to split up or stay together.” But he immediately realized the remark had a hollow ring. For Dessima would surely have been his least favorite patient had he felt the slightest emotional attachment toward any of them.